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OTTAWA — Ottawa’s older nursing homes are also the ones most prone to the spread of flu, colds and stomach bugs, Ottawa’s public-health unit says, a problem it’s trying to combat with specific training for the people who work in them.

“I think what we’ve learned over the last couple of years with this outbreak strategy, we’re looking at the facilities more on an individual basis and recognizing that one size does not fit all when it comes to outbreaks,” said Dr. Carolyn Pim, one of Ottawa’s associate medical officers of health.

Long-term-care homes need to report widespread or especially persistent clusters of those sicknesses, which are usually just nuisances to otherwise healthy people but which can be very dangerous to people who are elderly or already ill. Formally declared outbreaks mean residents’ activities and visitors are restricted to keep germs from spreading.

Last year was the worst for outbreaks in recent memory, with 88, but we’re now well past the peak of flu season and there have been only 33 since Sept. 1, when the health unit starts recording each year.

Ottawa’s 28 long-term-care homes get about 60 outbreaks between them each year, according to a report from the health unit, a number the homes and the health authorities have been trying to bring down. The raw numbers aren’t always helpful indicators of a problem Pim’s team needs to tackle: The Perley and Rideau Veterans’ Health Centre has had the most officially recorded outbreaks over the past three years, according to the health unit’s figures, with 15. But it’s also by far the largest, a 450-bed facility with a lot of residents with complicated needs. Factor that in and the Perley-Rideau drops way down the list.

At the top, over the past three years, is Bruyère Continuing Care’s residence at the north end of the ByWard Market, which has had seven outbreaks in a facility with 71 beds.

Pim wouldn’t talk about specific nursing homes, but the Bruyère residence is one of the city’s oldest.

“The age of the facility — the older facilities weren’t necessarily designed with modern understanding of infection control.” She added: “Now we’re looking for very readily accessible sinks for handwashing for the staff and for the residents. You may have, in the older facilities, more double rooms.”

That means more chances for contagious illnesses to spread from one roommate to another, or from one resident’s visitors to another’s.

“It’s the shared rooms,” said Donna Baker, a nurse and Bruyère’s manager of infection control. “There’s lots of transmission right there. Things happen before we know what’s going on.”

A long-term-care home is meant to have a family-like environment, she said, and that means a lot of people spending time with each other and taking part in the same activities. Illnesses spread while they’re incubating, before people show symptoms. Baker credited the health unit with organizing forums where specialists from different nursing homes have compared notes, with giving detailed training to workers, with supplying kits of supplies and fact sheets and posters (“from A to Z,” she said), and with promoting practices such as writing residents’ symptoms down and comparing them so patterns can be spotted faster.

At Bruyère, according to the health unit’s figures, that’s all made a huge difference: In a monitoring year that started Sept. 1, the Lowertown residence has cut its number of outbreaks to none.

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There are lots of other factors to consider, Pim pointed out as well, some of which can actually speak well of a nursing home whose numbers appear high. “If you have a higher-needs population, for example a greater number of people with dementia who might have challenges with personal hygiene, that can be a factor as well,” she said. “It may be that some facilities that have a higher number of outbreaks are more prompt and more complete with reporting them.”

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